MS‑DRG 242: Permanent Cardiac Pacemaker Implant with MCC

What Medicare paid hospitals for MS‑DRG 242 in 2024: nationally, state by state and across hospitals.

Paid per case$26,9611.8× the all-DRG average

Discharges9,7430.20% of all Medicare discharges

Total paid$262.7M64th largest MS‑DRG by spending

Hospitals513in 50 states and DC

Charges ÷ paid6.0×$160,492 average charge

Relative weight3.1236FY2027, 4.8-day geometric mean stay; FY2026 3.1928 (−2.2%)

In 2024 Medicare paid hospitals an average of $26,961 per discharge for MS‑DRG 242, across 9,743 fee-for-service discharges at 513 hospitals: 0.20% of all Medicare inpatient discharges and $262.7M in total, the 64th largest MS‑DRG by Medicare spending.

By state, the average ran from $15,882 in Vermont to $36,123 in California. Across hospitals, half were paid between $22,473 and $29,208 per case, and the median hospital $25,066; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $160,492 on average for these stays, 6.0 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 242 on the interactive map Price an MS‑DRG 242 claim at any hospital Every MS‑DRG

What changed in FY2027

The rates for discharges from October 1, 2026 (MS‑DRG version 44) against FY2026.

MS‑DRG 242, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	3.1928	3.1236	−2.2%
Geometric mean stay (days)	4.8	4.8	0.0
Average stay (days)	6.2	6.1	−0.1

Not capped: the −2.2% is CMS’s yearly recalibration of every weight from recent claims and cost data.
Name, MDC and transfer status are unchanged.

FY2027 national base payment (illustration)

$23,077.00

The FY2027 weight times the operating standardized amount and the capital rate ($6,848.00 + $539.95) at a wage index of 1.0. No IME, DSH, outlier or other hospital-specific adjustment, so it is not what any hospital is paid; price it at a hospital for that.

FY2027 national base payment across the severity levels of MS‑DRG 242
MS‑DRG	Severity	Payment ($)	Step ($)
242	with MCC	23,077.00	—
243	with CC	15,573.06	−7,503.94
244	without CC/MCC	13,030.87	−10,046.13

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 242 at a hospital

Paid per case, by state

MS‑DRG 242 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Maryland*	$38,086	173	10	1.2×
California	$36,123	680	45	7.0×
New York	$35,351	506	24	5.7×
Massachusetts	$33,895	394	17	3.0×
Hawaii	$32,874	24	2	4.3×
Connecticut	$32,784	71	3	3.8×
District of Columbia	$32,654	46	1	4.2×
Oregon	$31,074	99	5	3.3×
Wyoming	$30,845	13	1	3.6×
New Hampshire	$30,169	47	2	3.1×
New Jersey	$29,754	374	18	6.5×
Alaska	$29,486	32	1	6.6×
Minnesota	$28,516	317	10	4.5×
Nevada	$28,171	98	5	9.7×
Washington	$28,136	245	13	4.9×
Delaware	$27,243	58	3	3.9×
Idaho	$26,711	33	2	4.2×
Maine	$26,711	68	2	5.3×
Pennsylvania	$26,706	530	25	7.2×
Michigan	$26,318	269	14	4.4×
Rhode Island	$26,100	25	2	3.5×
Georgia	$25,837	207	12	7.0×
North Dakota	$25,614	65	4	3.5×
Arizona	$25,495	183	11	6.0×
Wisconsin	$25,251	112	5	4.2×
Ohio	$25,034	332	20	5.3×
South Dakota	$24,928	65	3	5.0×
Illinois	$24,817	337	20	5.0×
Montana	$24,612	45	2	3.0×
South Carolina	$24,572	221	10	7.8×
Virginia	$24,311	397	16	6.0×
Utah	$23,994	76	5	6.3×
West Virginia	$23,926	61	4	5.6×
Indiana	$23,906	254	14	5.5×
Texas	$23,831	774	41	8.8×
North Carolina	$23,810	318	13	5.0×
Colorado	$23,577	54	4	8.6×
Iowa	$23,370	137	7	4.3×
Kansas	$23,179	126	8	6.8×
Missouri	$23,152	168	11	4.7×
Florida	$23,128	828	46	8.5×
Kentucky	$23,089	125	8	6.7×
Tennessee	$22,506	227	13	6.5×
Louisiana	$21,738	53	4	4.9×
Alabama	$21,480	72	4	8.0×
Nebraska	$21,433	66	3	4.4×
Mississippi	$21,392	59	4	5.4×
Oklahoma	$21,374	130	7	5.7×
New Mexico	$21,160	46	3	6.5×
Arkansas	$19,884	72	5	4.0×
Vermont	$15,882	31	1	6.0×
United States	$26,961	9,743	513	6.0×

* Maryland hospitals are paid under the state’s all-payer model, not the IPPS, so Maryland is left out of the state range above.

How much hospitals vary

Each hospital’s own average Medicare payment for MS‑DRG 242.

10th percentile	$20,845
25th percentile	$22,473
Median hospital	$25,066
75th percentile	$29,208
90th percentile	$34,696

Related analysis

Transfers and the per-diem rule: when a short stay pays less than the full DRG · Inpatient DRG
DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity

The same condition at other severities

243Permanent Cardiac Pacemaker Implant with CC · $17,315
244Permanent Cardiac Pacemaker Implant without CC/MCC · $13,216

Nearby MS‑DRG numbers

Questions

What did Medicare pay for MS‑DRG 242 in 2024?

An average of $26,961 per discharge across 9,743 fee-for-service discharges at 513 hospitals, $262.7M in total.

Which state paid the most for MS‑DRG 242?

California, at $36,123 per case; Vermont paid the least, $15,882.

Where do these figures come from?

From the Medicare Inpatient Hospitals - by Provider and Service (data year 2024): the published hospital-by-DRG averages of Medicare fee-for-service inpatient discharges in 2024. Cells with fewer than 11 discharges are not published, so a hospital with a handful of cases is not counted. Average Medicare payment excludes the patient’s deductible and coinsurance.